Axicabtagene ciloleucel in vivo expansion and treatment outcome in aggressive B-cell lymphoma in a real-world setting
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Axicabtagene ciloleucel in vivo expansion and treatment outcome in aggressive B-cell lymphoma in a real-world setting. / Ayuk, Francis A; Berger, Carolina; Badbaran, Anita; Zabelina, Tatjana; Sonntag, Tanja; Riecken, Kristoffer; Geffken, Maria; Wichmann, Dominic; Frenzel, Christian; Thayssen, Guenther; Zeschke, Silke; Kröger, Nicolaus; Fehse, Boris.
in: BLOOD ADV, Jahrgang 5, Nr. 11, 08.06.2021, S. 2523-2527.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Axicabtagene ciloleucel in vivo expansion and treatment outcome in aggressive B-cell lymphoma in a real-world setting
AU - Ayuk, Francis A
AU - Berger, Carolina
AU - Badbaran, Anita
AU - Zabelina, Tatjana
AU - Sonntag, Tanja
AU - Riecken, Kristoffer
AU - Geffken, Maria
AU - Wichmann, Dominic
AU - Frenzel, Christian
AU - Thayssen, Guenther
AU - Zeschke, Silke
AU - Kröger, Nicolaus
AU - Fehse, Boris
N1 - © 2021 by The American Society of Hematology.
PY - 2021/6/8
Y1 - 2021/6/8
N2 - Data on the association between chimeric antigen receptor (CAR)-T-cell kinetics and patient outcome in the nontrial setting are missing, mainly due to the lack of broadly available CAR-T-cell diagnostic quantification tools. We performed prospective quantification of axicabtagene ciloleucel (axi-cel) in 21 patients treated for aggressive B-cell lymphoma at our clinic. Median peak CAR-T-cell count was 16.14 CAR-T cells/µL. Patients with 16.14/μL or higher peak CAR-T cells (strong expanders) had more day-30 objective responses (91% vs 40%, P = .02). In univariate analysis, peak CAR-T cell ≥ 16.14 (P < .001), normal platelet counts at start of lymphodepletion (P < .001), no prior stem cell transplant (P = .04), and peak CAR-T cells as continuous variable (P = .03) were associated with better progression-free survival (PFS). After adjusting for platelet counts and prior stem cell transplantation, peak CAR-T cells below median was still associated with shorter PFS (relative risk, 0.15, 95% confidence interval, 0.04-0.59, P = .007). Low platelet counts also maintained significant impact on PFS. Our data demonstrate association of axi-cel levels and outcome in a nontrial setting and for the first time use a cutoff to segregate weak and strong expanders with respective outcomes.
AB - Data on the association between chimeric antigen receptor (CAR)-T-cell kinetics and patient outcome in the nontrial setting are missing, mainly due to the lack of broadly available CAR-T-cell diagnostic quantification tools. We performed prospective quantification of axicabtagene ciloleucel (axi-cel) in 21 patients treated for aggressive B-cell lymphoma at our clinic. Median peak CAR-T-cell count was 16.14 CAR-T cells/µL. Patients with 16.14/μL or higher peak CAR-T cells (strong expanders) had more day-30 objective responses (91% vs 40%, P = .02). In univariate analysis, peak CAR-T cell ≥ 16.14 (P < .001), normal platelet counts at start of lymphodepletion (P < .001), no prior stem cell transplant (P = .04), and peak CAR-T cells as continuous variable (P = .03) were associated with better progression-free survival (PFS). After adjusting for platelet counts and prior stem cell transplantation, peak CAR-T cells below median was still associated with shorter PFS (relative risk, 0.15, 95% confidence interval, 0.04-0.59, P = .007). Low platelet counts also maintained significant impact on PFS. Our data demonstrate association of axi-cel levels and outcome in a nontrial setting and for the first time use a cutoff to segregate weak and strong expanders with respective outcomes.
U2 - 10.1182/bloodadvances.2020003959
DO - 10.1182/bloodadvances.2020003959
M3 - SCORING: Journal article
C2 - 34100900
VL - 5
SP - 2523
EP - 2527
JO - BLOOD ADV
JF - BLOOD ADV
SN - 2473-9529
IS - 11
ER -
